Success Fee: No Success, No Fee
For the past 12 years South Florida Utilization Review South Florida Utilization Review has negotiated millions in savings on hospital, ambulatory surgery center and surgeon bills for our workers’ compensation payers across the country. Led by Joel Grossman, M.D. , Certified Medical Audit Specialist and Certified Professional Coder, and knowledgeable about all the state fee schedules, our team of audit specialists will undertake negotiation at no charge to you, the payer, until such time as you receive our legally binding Agreement signed by the facility or surgeon designee.
Do not wish a negotiation? At your request Bill Analysis or Concurrence with fee schedule can be undertaken.
We do the work. You enjoy the savings.
Every month there is an article about a hospital or chain of hospitals settling civil whistleblower lawsuits, repaying overcharges, duplicate charges and phantom charges. Implants costing the hospital thousands of dollars are marked up 400% or more. At the same time hospitals, through mergers and acquisitions, are using their increased market power to compel insurers to contract for higher reimbursement. Yet hospital, ambulatory surgery center and surgeon’s bills vary widely — even within a particular geographical area – - with price discrepancies ranging as much as 40%. For the insurer, the task of debt analysis and debt reduction becomes an important strategy in remaining competitive and in retaining customers.
The insurer that pays the bill in full as it presented, with no more than a pro forma scrutiny, and that hopes that a network savings will suffice, will in the end lose customers and cease to be competitive. South Florida Utilization Review offers a solid Agreement, legally binding, a resolution of this large claim. The South Florida Utilization Review Agreement means that there will thus be no dispute about the ‘re-pricing done by some bill review company that arbitrarily inputs figures that are not supported. A ‘payment” based on a “re-pricing” can be disputed by the hospital or ambulatory surgery center, and is fraught with the potential for fines and litigation.
South Florida Utilization Review has the knowledge, experience and contacts to do Bill Negotiation. We can put our skills to work for you.
